Avandia

Dec 7, 2003

I am on 4mg of Avandia to help facial lipoatrophy . I have been on it for about 9 months now and have not seen any improvement, maybe in fact a slight worsening (though that could be the meds or ?) The meds I am on are the friendlier ones (abc, viread, viramune). My question is could the avandia be making the lipo worse? Is it worth staying on the avandia for at least a full year or just stop now since I am seeing no difference? I know it may take a year or more for some fat to recover. Thank you for your time.

Response from Dr. Conway

Three studies have reported the effects of therapy with rosiglitazone (Avandia). Jarvinen and colleagues from Helsinki performed a placebo-controlled trial using 8 mg of rosiglitazone for 6 months, and was unable to show a statistically significant difference in either visceral or subcutaneous fat. Gelato and colleagues from Stony Brook Hospital in New York performed an open-label study in 8 subjects, and demonstrated a 23% increase in mean sub-cutaneous fat. Hadigan presented the results of a randomized, placebo-controlled trial of rosiglitazone at the recent 5th Workshop on Lipodystrophy. Therapy was placebo-controlled for 3 months, and then followed by 3 months of open-label therapy (so total therapy for 6 months). A 5% increase in leg fat was noted at 3 months, and a 12% increase in abdominal fat at 6 months. I am not aware of any information suggesting a worsening of fat loss with Avandia. My colleague Dr. Moyle suggests there may be more data at the Retrovirus meeting in February 2004. If I were you, I might wait until then to review the information and make up your mind, paying attention to the dose and duration of Avandia therapy that will have been shown to work.

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